Electrophysiological signal monitoring including ECG signal and intra-cardiac electrogram monitoring is commonly used for patient health status evaluation. ECG signal morphologies are used to diagnose patient cardiac rhythm and health status. However known analysis and interpretation of a continuous single dimensional ECG waveform is subjective and needs extensive clinical experience for CRM (cardiac rhythm management). CAD (Coronary Artery Disease) and heart-related problems and cardiac arrhythmias are serious health problems. A 12-lead electrocardiogram (ECG) and multi-channel intra-cardiac electrograms (ICEGs) are diagnostic reference standards used for evaluating cardiac rhythm and events. Known waveform morphology and time domain parameter analysis, such as of a P wave, QRS complex, ST segment and T wave, are used for cardiac arrhythmia monitoring and identification, e.g. atrial fibrillation (AF), myocardial ischemia (MI), ventricular tachycardia/fibrillation (VT/VF). However, continuous waveform morphology and time domain parameter analysis is sometimes subjective and time-consuming, and requires extensive expertise and clinical experience for accurate interpretation and proper cardiac rhythm management.
Known clinical methods and approaches for ECG waveform monitoring and diagnosis typically involve 1-dimensional heart beat signal waveform and morphology analysis or involve analysis concerning a 0.1 mV elevation of an ST segment for myocardial ischemia (an ST segment is usually determined by using R wave detection). Furthermore, known ECG waveform analysis typically focuses on the time domain or frequency domain calculation of a single or averaged heart cycle signal. Known clinical diagnosis, monitoring and detection methods, such as Holster monitoring use one dimensional signal comparison and visualization for multi-heart beat signals. These known systems only use R wave synchronization for signal comparison and are unable to track the location of the arrhythmia and are unreliable or insensitive to early small signal changes and variation. Additionally, cardiac electrophysiological activities and signals (ECG and ICEG) are time varying and known signal calculation and related analysis usually is unable to localize a precise malfunction severity and trend of the cardiac events (e.g., of myocardial ischemia and infarction), such as cardiac pathology irregularity stages and arrhythmia occurrence.
Known clinical diagnosis is unable to comprehensively link real time ECG sequential signals and cardiac function, such as ECG signal abnormality with an object in a functional image as an anatomical mapping, which may be used for accurate cardiac arrhythmia localization, type identification, severity characterization, and corresponding clinical treatment. Known ECG and electrophysiological signal monitoring systems usually involve one dimensional waveform morphology analysis of multiple ECG signal channels (such as lead I, II, III, for example). Known ECG and electrophysiological signal diagnosis and evaluation depend on physician and cardiologist experience and knowledge. Known systems also lack criteria for quantitative diagnosis and characterization of a sequential ECG signal trend, especially in an early stage of cardiac events. A system according to invention principles addresses these deficiencies and related problems.